Influence of Curing Time, Overlay Material and

Thickness on Three Light-curing Composites

Used for Luting Indirect Composite Restorations
Camillo D’Arcangeloa/Francesco De Angelisb/Mirco Vadinic/Fabio Carluccioc/
Laura Merla Vitaloned/Maurizio D’Amarioe

Purpose: To assess the microhardness of three resin composites employed in the adhesive luting of indirect
composite restorations and examine the influence of the overlay material and thickness as well as the curing
time on polymerization rate.
Materials and Methods: Three commercially available resin composites were selected: Enamel Plus HRI
(Micerium) (ENA), Saremco ELS (Saremco Dental) (SAR), Esthet-X HD (Dentsply/DeTrey) (EST-X). Post-polymer-
ized cylinders of 6 different thicknesses were produced and used as overlays: 2 mm, 3 mm, 3.5 mm, 4 mm,
5 mm, and 6 mm. Two-mm-thick disks were produced and employed as underlays. A standardized amount of
composite paste was placed between the underlay and the overlay surfaces which were maintained at a fixed
distance of 0.5 mm. Light curing of the luting composite layer was performed through the overlays for 40,
80, or 120 s. For each specimen, the composite to be cured, the cured overlay, and the underlay were made
out of the same batch of resin composite. All specimens were assigned to three experimental groups on the
basis of the resin composite used, and to subgroups on the basis of the overlay thickness and the curing
time, resulting in 54 experimental subgroups (n = 5). Forty-five additional specimens, 15 for each material
under investigation, were produced and subjected to 40, 80, or 120 s of light curing using a microscope glass
as an overlay; they were assigned to 9 control subgroups (n = 5). Three Vicker’s hardness (VH) indentations
were performed on each specimen. Means and standard deviations were calculated. Data were statistically
analyzed using 3-way ANOVA. Within the same material, VH values lower than 55% of control were not consid-
ered acceptable.
Results: The used material, the overlay thickness, and the curing time significantly influenced VH values. In the
ENA group, acceptable hardness values were achieved with 3.5-mm or thinner overlays after 120 or 80 s curing
time (VH 41.75 and 39.32, respectively), and with 2-mm overlays after 40 s (VH 54.13). In the SAR group, ac-
ceptable hardness values were only achieved with 2-mm-thick overlays after 120 or 80 s curing time (VH 39.81
and 29.78, respectively). In the EST-X group, acceptable hardness values were only achieved with 3-mm or thin-
ner overlays, after 120 or 80 s curing time (VH 36.20 and 36.03, respectively).
Conclusion: Curing time, restoration thickness, and overlay material significantly influenced the microhardness
of the tested resin composites employed as luting agents. The clinician should carefully keep these factors
under control.
Keywords: indirect composite restoration, luting, Vickers hardness.
J Adhes Dent 2012; 14: 377–384. Submitted for publication: 26.06.10; accepted for publication: 10.07.11
doi: 10.3290/j.jad.a22765

a Aggregate Professor, Chairman of Department of Operative Dentistry, Dental d Research Associate, Department of Operative Dentistry, Dental School,
School, University of Chieti, Chieti, Italy. Idea, hypothesis, experimental de- University of Chieti, Chieti, Italy. Performed Vicker’s indentation, co-wrote
sign, proofread manuscript, contributed to discussion. manuscript.
b Research Associate, Department of Operative Dentistry, Dental School, e Research Associate, Department of Restorative Dentistry, Dental Clinic,
University of Chieti, Chieti, Italy. Experimental design, consulted on and per- University of L’Aquila, L’Aquila, Italy. Proofread manuscript, contributed to
formed statistical evaluation, SEM analysis, wrote manuscript, contributed discussion.
to discussion.
Correspondence: Camillo D’Arcangelo, Department of Oral Science, Dental
c Research Associate, Department of Operative Dentistry, Dental School, Uni- School, University “G. D’Annunzio”, Via dei Vestini 31, 66100 Chieti, Italy.
versity of Chieti, Chieti, Italy. Sample preparation. Tel: +39-085-454-9652, Fax: +39-085-454-1279. e-mail: [email protected]

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D’Arcangelo et al

T he ever-increasing demand for esthetic restorations

has revolutionized modern dentistry and brought
about the widespread use of resin composites. The
MATERIALS AND METHODS
Three commercially available resin composites were
achievement of a proper degree of conversion is of para- selected for this study: Enamel Plus HRI (shade UD2,
mount clinical importance for these materials, as unre- Micerium, Avegno; Genova, Italy), Saremco ELS (shade
acted monomers and inadequate polymerization may A2, Saremco Dental; St.Gallen, Switzerland), and
compromise mechanical behavior under masticatory Esthet-X HD (shade A2, Dentsply DeTrey; Konstanz,
loads, leading to increased wear,17 solubility, dimen- Germany) (Table 1). Specimen preparation for hardness
sional instability, color change, and reduced biocompat- measurements was performed as proposed by Ruegge-
ibility,2 which may consequently affect the restoration’s berg and Craig28 and shown in Fig 1.
longevity and ultimate clinical success.11,34 Inadequate
polymerization occurs if the composite resin does not Manufacture of Resin Composite Overlays
receive an adequate number of photons during the light- and Underlays
curing process.23 Composite pastes were placed into cylindrical molds
In accordance with respective clinical indications, with a 10-mm inner diameter. Layering was carried
resin composite materials are suitable for use for both out in five increments of ca. 2 mm each, which were
indirect and direct restorations. Among the parameters individually light polymerized for 40 s (T-LED, Anthos;
that may influence the clinical success of indirect resto- Imola, Italy) with a 1380 mW/cm2 output. After remov-
rations, a proper degree of polymerization of the resin ing the molds, the 10-mm-high composite cylinders were
luting agent should be taken into account.1 The adhesive subjected to an additional cycle of polymerization in a
luting of indirect restorations can be performed employ- composite oven at 70°C for 10 min (Bulb PlusT; Micer-
ing both dual-curing and light-curing cements.7-15 An ad- ium).7,8 In order to obtain disks with perfectly flat and
vantage of dual-curing materials is their self-curing com- parallel circular bases, cured cylinders were secured on
ponent, which favors conversion even in the presence of the arm of a Micromet M machine (Remet, Casalecchio
scarce radiant energy; however, a disadvantage is that di Reno; Bologna, Italy) and subjected to consecutive
they have a relatively low viscosity and require a mixture cuts perpendicular to their long axis. The distance be-
of two elements, which promotes the formation of porosi- tween the consecutive cuts was regulated to produce
ties or voids and the incorporation of bubbles. On the cylinders with 6 different thicknesses: 2 mm, 3 mm,
other hand, light-curing materials used as luting agents 3.5 mm, 4 mm, 5 mm, and 6 mm. The thickness of each
are easily handled and are characterized by controllable cylinder was controlled using a digital caliper (series
curing times that create high quality margins.1 With no 500 caliper, Mitutoyo America; Aurora, IL, USA) with an
time restriction, it is easier to achieve a full seating of accuracy of 0.01 mm.
the inlay/onlay and to accurately remove all the excess For each of the 3 resin composites under investiga-
cement, which improves the overall restoration quality. tion, 90 cylinders to be used as overlays were produced,
Only their light activation can constitute a disadvantage, 15 for each different thickness, resulting in a total of
since light polymerization of all portions of the cement 270 cylinders. Moreover, further cylinders having a fixed
may not always be possible, if the inlay is thick enough thickness of 2 mm were similarly prepared and served as
to significantly impair light penetration.21 underlays (Fig 1).
Different methods exist to determine the degree of po-
lymerization.11 However, as hardness is considered one Specimen Production for Experimental Groups
of the most important properties of a resin composite6,26 One surface of each overlay was subjected to airborne
and gives a good indication of the conversion of double particle abrasion with 50-μm Al2O3 (Korox, Bego; Bre-
bonds, hardness measurements are often used to de- men, Germany) using an intraoral air-abrasion device
termine the extent of polymerization of a resin compos- (Dento-Prep, Micerium). The tip of the microetcher was
ite.9,16 Because higher hardness values are considered kept 5 cm away from the surface and applied for 10 s
an indirect indication of greater material polymerization, at 2.0 bar pressure.7 The surfaces were then water
microhardness assessment has become a widely ac- rinsed and thoroughly dried. A layer of bonding agent
cepted indirect method to effectively assess the degree was applied with a microbrush to the sandblasted
of cure for resin composites.11,32 surfaces and gently dried to evaporate the solvent.
The aim of the present study was to assess the micro- The adhesive systems used were: EnaBond (Micerium)
hardness of three commercially available resin compos- for Enamel Plus HRI specimens, James-2 (Saremco
ites employed in the adhesive luting of indirect compos- Dental AG) for Saremco ELS specimens, and XP Bond
ite restorations, and evaluate the effect of the conver- (Dentsply DeTrey) for Esthet-X HD specimens. The ma-
sion rate of the overlay material, overlay thickness, and terials used are summarized in Table 1. A standardized
of curing time on the microhardness. The null hypothesis amount of composite paste was placed between the
tested was that the microhardness values would not be underlay and the overlay bonding surface under low
affected by type of resin composite, overlay thickness, or lighting conditions to inhibit photoactivation. A 0.5-mm-
curing time. thick metal ring was kept between the underlay and
the overlay in order to keep them at a fixed distance,
thus ensuring a standard thickness of the composite

378 The Journal of Adhesive Dentistry

 D’Arcangelo et al

Light curing unit

Cured overlay of varying

Fig 1 Cross section of thickness Cured overlay of varying
specimen preparation (a) thickness
and final specimen shape 0.5 mm metal ring Composite to be cured metal ring
(b) showing the 0.5-mm- Cured composite underlay 40, 80 or 120 s
curing time Composite layer tested for VH 0.5 mm
thick resin layer to be
subjected to Vickers Hard- a b
ness test.

Table 1 Summary of the materials used in experimental groups

Groups Bonding Resin compos- Resin matrix Filler Content % Manufacturer

agent ite (Batch no.) (w/v)
ENA EnaBond Light Enamel Plus HRI Bis-GMA, UDMA, Glass filler, SiO2 75/53 Micerium, Avegno;
curing (2009000112) TEG-DMA Genova, Italy

SAR James-2 Saremco ELS Bis-GMA, bis- Ba-Al-B-Si glass, 77/60 Saremco Dental;
(06.2013-72) EMA, IBMA Ba glass St.Gallen, Switzerland

EST-X XP Bond Esthet-X HD Bis-GMA, bis- Ba-F-Al-B-Si glass, 74/<50 Dentsply DeTrey;
(0410085) EMA, TEG-DMA SiO2 Konstanz, Germany

to be cured. A 0.05-mm-thick transparent polyethylene Vicker’s Hardness Measurement

strip between the underlay and the uncured composite Vicker’s hardness (VH) readings were recorded on the
was used to avoid bonding at this interface. For each free surface of the 0.5-mm-thick composite layer that
specimen, the 0.5-mm composite layer to be cured, was light-cured through the overlay (Fig 1). For each
the cured overlay, and the underlay were made out of specimen, the mean value of three VH readings per-
the same batch of resin composite. The 270 speci- formed at approximately 2 mm distance from one an-
mens – assigned to three experimental groups on the other was used as the raw datum. Vicker’s indentations
basis of the resin composite used (Enamel Plus HRI: were produced by applying a 10-N load for 10 s using a
ENA group; Saremco ELS: SAR group; Esthet-X HD: universal testing machine with a 500-N load cell (Lloyd
EST-X group) and to subgroups on the basis of the LR 30K, Lloyd Instruments; Fareham, UK) provided with
overlay thickness (2, 3, 3.5, 4, 5, and 6 mm) – were a standard 136-degree Vicker’s diamond indenter (item
divided again into further subgroups on the basis #17, Affri, Induno Olona; Varese, Italy). Scanning elec-
of the light-curing time, ie, 40, 80, or 120 s (T-LED, tron microphotographs (EVO 50 XVP LaB6, Carl Zeiss;
Anthos SRL), resulting in a total of 54 experimental Cambridge, UK) were taken at different magnifications
subgroups composed of 5 specimens each (n = 5). in order to measure the linear extent of the indenta-
Moreover, 9 control groups (n = 5), equally divided by tion diagonals (Figs 2 to 4). Subsequently, VH numbers
the three materials and the three curing times, were were calculated according to the following formula:
added using microscopic slides to simulate completely
transparent overlays. Polymerization was performed VH = (1.854 x F)/[(d1+d2)/2]2,
by placing the curing unit tip in direct contact with the
overlay’s upper surface. In this way, the underlays where d1 and d2 are the measured diagonals (mm)
served as reflective material, while the cured overlays and F is the predetermined applied load expressed in
of varying thickness were used to control the amount kilograms-force (1.0204 Kg).
of light reaching the composite to be cured and hence
its degree of conversion. The obtained specimens, the Statistical Analysis
shape of which is depicted in Fig 1, were stored at room Data were arranged on the basis of the three factors
temperature in black film canisters for at least 24 h be- under investigation (material, overlay thickness, and cur-
fore subsequent procedures. ing time). Means and standard deviations were calculated.

Vol 14, No 4, 2012 379

D’Arcangelo et al

a b

Fig 2 Scanning electron micrograph showing a VH indentation (a) and the measurement of its diagonals (b) on one specimen from
the SAR group, 3 mm thick and cured for 80 s.

a b

Fig 3 Scanning electron micrograph showing the VH indentation (a) and the measurement of its diagonals (b) on one specimen
from the ENA group, 2 mm thick and cured for 80 s.

a b

Fig 4 Scanning electron micrograph showing the VH indentation (a) and the measurement of its diagonals (b) on one specimen
from the EST-X group, 3.5 mm thick and cured for 80 s.

380 The Journal of Adhesive Dentistry

 D’Arcangelo et al

Table 2 Mean VH numbers and standard deviations (SD) for experimental groups

ENA Thickness
Control 2 mm 3 mm 3.5 mm 4 mm 5 mm 6 mm
Curing Time 40 s 66.21a1 54.13b2 27.40c2 24.32c2 10.95d2 1.84e3 -------- Mean

(4.20) (1.98) (5.19) (1.17) (1.98) (0.51) -------- (SD)

80 s 66.32a1 59.47b1 47.53c1 39.32d1 22.35e1 6.39f2 -------- Mean

(2.07) (0.49) (2.98) (0.46) (3.06) (3.22) -------- (SD)

120 s 67.96a1 61.41b1 48.23c1 41.75d1 23.37e1 13.77f1 -------- Mean

(1.83) (4.30) (1.66) (8.29) (3.54) (5.94) -------- (SD)

SAR Thickness

Control 2 mm 3 mm 3.5 mm 4 mm 5 mm 6 mm
Curing Time 40 s 42.88a1 16.51b3 9.62c2 6.18c3 1.02d3 -------- -------- Mean

(0.54) (3.33) (0.96) (0.93) (0.44) -------- -------- (SD)

80 s 43.90a1 29.78b2 19.59c1 12.06d2 9.64d2 0.66e1 -------- Mean

(1.32) (5.66) (2.44) (1.97) (1.14) (0.12) -------- (SD)

120 s 44.44a1 39.81a1 20.35b1 16.91b,c1 14.57c1 1.38d1 -------- Mean

(0.94) (0.48) (2.19) (0.39) (2.38) (0.53) -------- (SD)

EST-X Thickness
Control 2 mm 3 mm 3.5 mm 4 mm 5 mm 6 mm
Curing Time 40 s 58.04a1 17.66b3 14.02b2 5.20c2 2.47c2 -------- -------- Mean

(4.16) (9.15) (0.53) (0.26) (0.09) -------- -------- (SD)

80 s 60.56a1 44.36b2  36.03c1 16.73d1 10.33e1 0.57f1 -------- Mean

(5.43) (1.36) (4.01) (3.19) (1.84) (0.05) -------- (SD)

120 s 61.32a1 49.93b1 36.20c1 16.27d1 11.52e1 5.61f1 -------- Mean

(1.50) (4.56) (5.16) (0.86) (1.27) (0.31) -------- (SD)

Means and standard deviations for Vickers Hardness numbers obtained in the experimental groups and arranged on the basis of the material employed,
the interposed composite disk thickness, and the curing time. Same superscript lower-case letters indicate no statistically significant differences among the
levels of the factor thickness (reading horizontally). Different superscript numbers indicate significant differences among the levels of curing time (reading
vertically). Mean values in bold were at least 55% of the respective control group.

The effect of the three factors on the mean VH values was ness, and the curing time (p < 0.05). Moreover, all the
analyzed using a three-way ANOVA. Multiple comparisons interactions among the three factors were statistically
were performed according to the Holm-Sidak method. significant (p < 0.05). Mean VH values, standard devia-
Values of p < 0.05 were considered to be statistically sig- tions, and the Holm-Sidak test results are summarized
nificant in all tests. Silikas et al30 suggested that degree in Table 2 and in Fig 5.
of conversion values below 55% might be contraindicated. In the ENA group, clinically acceptable hardness values
As a consequence, for each different tested material and (at least 55% of the control) were achieved after 120 s
curing time, VH values below 55% of the respective con- or 80 s curing time using 3.5-mm-thick (VH 41.75 and
trol group were not considered clinically suitable. 39.32, respectively) or thinner overlays, and after 40 s
using a 2-mm overlay (VH 54.13). In the SAR group, accept-
able hardness values were only achieved after a 120-s or
RESULTS 80-s curing time using 2-mm-thick overlays (VH 39.81 and
29.78, respectively). In the EST-X group, acceptable results
Three-way ANOVA showed that mean VH values were were only achieved using 3-mm or thinner overlays, after
statistically influenced by the material, the overlay thick- curing times of 120 s or 80 s.

Vol 14, No 4, 2012 381

D’Arcangelo et al

80.00 ENA Thickness

Control
2 mm
3 mm
60.00 3,5 mm
4 mm
5 mm
Mean VH

40.00

20.00

0.00
40_Sec 80_Sec 120_Sec
Curing Time
Error bars: 95% Cl

50.00 SAR Thickness

Control
2 mm
3 mm
40.00 3,5 mm
4 mm
Mean VH

5 mm
30.00

20.00

10.00

0.00
40_Sec 80_Sec 120_Sec
Curing Time
Error bars: 95% Cl

70.00 EST-X Thickness Fig 5 Bar charts sum-

Control
2 mm marizing mean Vicker’s
60.00
3 mm Hardness (VH) values and
3,5 mm
50.00 4 mm
95% confidence intervals
5 mm obtained for the three ma-
Mean VH

40.00 terials under investigation

(ENA, SAR, EST-X), using
30.00
different thickness over-
20.00 lays and after 40, 80 or
120 s curing time. The
10.00 horizontal lines indicate
0.00
55% of each respective
40_Sec 80_Sec 120_Sec control group VH value,
Curing Time used as acceptability
Error bars: 95% Cl threshold for each differ-
ent material.

Measurable VH readings were not performed in 6-mm- thicknesses that may commonly occur clinically. As a
thick overlay subgroups, as indentation diagonals were consequence, adequate light polymerization of all por-
not clearly detectable on the most undercured specimens. tions of the light-cured cement does not always appear
A similar finding was also observed in SAR and EST-X to be possible. Hence, the clinician should carefully
5-mm overlay subgroups subjected to a 40 s curing time. keep this factor under control by modifying the cavity
shape with a direct resin composite buildup. The influ-
ence of the restoration thickness on the material’s
DISCUSSION degree of conversion was previously investigated by
Musanje and Darvell,19 who showed a dramatic attenu-
The results of the present study confirmed that resin ation in irradiance with increasing specimen thickness.
composite overlays can significantly disperse the light This attenuation is expected to be dependent in part on
from the curing unit when it passes through, even for filler volume fraction, particle size distribution, particle

382 The Journal of Adhesive Dentistry

 D’Arcangelo et al

shape, refractive index difference (compared with the was cross linked.29 Rode et al27 showed a high correla-
matrix) of the resin composite material, and in part on tion between resin composite microhardness and degree
the decrease in light intensity with increasing distance of conversion. Thus, hardness measurements are widely
from the composite surface.1,2 used to evaluate resin composite cure and provide a good
Based on the obtained data, the null hypothesis must estimate of the degree of conversion of composite materi-
be rejected. In all tested groups, significant differences als.11,16,32
in the microhardness of resin composites used as a lut- Ilie et al14 showed that at 2 mm depth, an increase
ing agent were observed for the different curing times in polymerization time increased all the measured
employed. Longer curing times (at least 80 s) led to an properties, including hardness, modulus of elasticity,
improved degree of conversion of the luting agent, even creep, and elastic-plastic deformation. Moreover, mech-
if no differences concerning the clinical suitability of the anical properties varied strongly as a function of the
polymerization extent were recorded between 80-s and spatial regions and a significant correlation was found
120-s subgroups. between all of them. In a recent study, Bhamra et al3
Different VH results were also observed when corre- evaluated hardness and flexural properties of four com-
sponding shades from different manufacturers (Enamel mercially available resin composite restorative materi-
Plus HRi UD2, Saremco ELS A2 and Esthet-X HD A2) were als subjected to different light-curing procedures using
used as overlay and luting agent, suggesting that the irradiation times recommended by manufacturers: no
inherent translucency of the chosen material should be detectable effect on strength or stiffness was recorded,
accurately considered. Regardless of the curing time, in although indentation hardness showed clearly that while
the ENA group, a proper polymerization of the luting agent the top surface was always adequately cured, the bot-
(55% of the control, as suggested by Silikas et al30) was tom surface at the recommended maximum increment
achieved with overlay thicknesses ranging between 3.5 thickness was not. A bottom hardness that is 80% of the
and 2 mm; in the EST-X group, overlay thicknesses above top hardness value is generally considered adequate for
3 mm resulted in an inadequate degree of conversion; in a 2-mm increment.10
the SAR group, just the 2 mm overlay led to a proper po- However, in the present study, to imitate the clinical
lymerization. As a consequence, when dealing with thick procedure of luting an indirect restoration, irradiation of
and less translucent indirect composite restorations, a the composite layer under investigation was performed
dual-curing cement seems more suitable; in contrast, through a heat-cured overlay. This study design did not
translucent materials used at the appropriate thickness allow the measurement of any top hardness value to be
seem to allow the clinician to employ the same material used as reference. Silikas et al30 suggested that degree
for the build-up procedures, indirect restoration manufac- of conversion values below 55% might be contraindicated.
ture, and cementation. This is particularly important at the As a consequence, although degree of conversion and
margins between tooth and restoration. Marginal adapta- hardness are not identical, as they are two different prop-
tion of indirect composites before cementation has been erties that can just be related one to the other, VH values
reported to range widely, between 20 and 718 μm.22-25 below 55% of the respective control group were not con-
As a consequence, the material that fills this gap should sidered clinically suitable in this study.
preferably have mechanical properties (eg, wear resist- Several types of light-curing unit (LCU) are currently
ance) comparable to those of the restoration. To obtain used for photopolymerization of light-activated compos-
this, a filler content of at least 70%, as in microhybrid com- ite resins: conventional quartz-tungsten-halogen (QTH),
posites, would be necessary, whilst common dual-curing light-emitting diode (LED), plasma arc, or laser. The most
cements have a reduced filler content and mechanical commonly used are the QTH and LED light.24 Ceballos
properties similar to those of flowable resins. Moreover, et al6 concluded that the type of light-curing unit (LED vs
with light-curing composites employed as luting agents, QTH halogen) had no influence on curing effectiveness;
the necessary working time for seating the restoration instead, microhardness results were significantly affected
and removing the excess cement may be extended at by the interaction between the type of curing light and ex-
the discretion of the clinician, overcoming the relatively posure time and also by the interaction between the type
restricted working time imposed by self-curing cements. of curing light and depth. However, using an old dilapi-
In this study, an indirect method such as hardness dated QTH LCU, light-activated dental materials may be
testing was used to evaluate curing effectiveness. Vari- less effectively polymerized, resulting in poorer physical
ous methods exist to assess the degree of conversion properties and an increased risk of premature failure of
of resin composites. Direct techniques include Fourier restorations, assuming no compensation for decreased
transform infrared spectroscopy (FTIR) or Raman spec- LCU irradiance.31 Cavalcante et al5 showed that the expo-
troscopy, which allow a direct measure of differences sure time required to stabilize hardness values of resin
in the degree of C=C conversion.13,28 However, these composites is affected not only by resin composite formu-
techniques are time consuming, complex6,28 and, accord- lation but also by the type of LCU. This probably indicates
ing to some authors,6,33 more qualitative than quantita- that actual power density and degree of collimation of the
tive in nature. In contrast, indirect methods are relatively LCU used are other important variables to be investigated.
easy to perform.6,20 Moreover, it has been shown that the In the present study, these variables were not considered,
hardness tests were more sensitive than FTIR to detect since the same commercially available, new-model LED
small changes in degree of conversion after the network LCU was used for all specimens.

Vol 14, No 4, 2012 383

D’Arcangelo et al

17. Manhart J, Kunzelmann KH, Chen HY, Hickel R. Mechanical properties

CONCLUSION and wear behaviour of light-cured packable composite resins. Dent
Mater 2000;16:33-40.
Within the limitations of the present in vitro study, VH val- 18. Mitchem JC, Wagner PC, Ferracane JL. Marginal adaptation of the Con-
ues (and thus degree of conversion) of the tested resin cept inlay system. Am J Dent 1994;7:232-234.
composites used as luting agents were affected by the 19. Musanje L, Darvell BW. Curing-light attenuation in filled resin restorative
materials. Dent Mater 2006;22:804-817.
curing time, indirect restoration thickness, and the inher-
20. Neo BJ, Soh MS, Teo JW, Yap AU. Effectiveness of composite cure
ent translucency of the overlay material. With at least associated with different light-curing regimes. Oper Dent 2005;30:671-
80 s of curing time, a 3.5-mm thickness limit should not 675.
be exceeded even when using translucent materials, if a 21. Ozyesil AG, Usumez A, Gunduz B. The efficiency of different light
sources to polymerize composite beneath a simulated ceramic restora-
light-curing composite must be used for cementation. For tion. J Prosthet Dent 2004;91:151-157.
luting thicker and more opaque indirect restorations, a 22. Peutzfeldt A, Asmussen E. A comparison of accuracy in seating and
dual-curing luting agent is suggested. gap formation for three inlay/onlay techniques. Oper Dent 1990;15:
129-135.
23. Price RB, Felix CA, Andreou P. Effects of resin composite composition
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384 The Journal of Adhesive Dentistry